ted fellows

Fellows Friday with Daniel Zoughbie

With Microclinic International, Daniel Zoughbie is making health contagious, and believes that it’s critical to peace and stability in the Middle East.

Microclinic International has a unique philosophy of “contagious health.” What does that mean?

Common sense tells us that negative things like violence, smoking behaviors and unhealthy eating habits are socially contagious: they spread from person to person, family to family, and are even influenced by television and other things. If this is the case, why can’t we make healthy behaviors contagious? Why can’t we make a positive health epidemic? We can use these strong social interactions to actively prevent the spread of major chronic disease epidemics, and perhaps even reverse them.

What are micro-clinics, and how do they work?

 Micro-clinics are not an infrastructure of buildings; they’re an infrastructure of people, of human relationships. At Microclinic International, we recognize that we did not create these infrastructures: they already exist in a community. It’s important for us to find good local partners, we work with doctors and nurses, gain their local expertise and train them in ours. Then we recruit people to join our micro-clinic groups. We don’t ask them to come as individuals; they have to come as groups. Naturally, they bring their husband, wife, sister, cousin, or best friend who lives next door…

Together, they all go through the program, which shares access to basic education about the disease. They learn how to change important behaviors like how they eat and exercise. They learn about medication, how to take it, how to use certain technologies like a glucose monitoring system, and how to interact with their doctor. They participate in group activities such as, eating healthy meals together.

Because they go through the program as a group, there’s less chance of being ridiculed at home for eating strange foods or coming up with weird ideas from strange doctors and nurses. The group acts as a support system and the positive changes are implanted back into the home. If the husband — in a traditional culture — says, “We’re going to eat healthy meals,” and the wife (it is usually the women who cook) has the ability to prepare the meal, then the other members of the family will not put up as much resistance. Maybe the children will even encourage the parents to exercise. They all learned together, and they made friends with other people going through similar problems.

Microclinic International initiated programs in the Middle East in 2005, yet you’ve already expanded to four different continents.

Yes, we initially focused on diabetes, first in Palestine, and now in Jordan and India.

In Kenya we’re working on the HIV/AIDS epidemic. The project is based on Mfangano Island in the middle of Lake Victoria. Kenya suffers from one of the highest HIV/AIDS infection rates in the world, not to mention the economy is simply devastated. This project is particularly interesting because we’re working closely with the Organic Health Response, which has built a solar powered community center that will have Internet access. People will have the incentive and cover to come to the clinic for the Internet, and then once they are tested for HIV/AIDS, they can be placed in micro-clinic groups.  This will reduce the stigma.

Interestingly, we’re now bringing the insights we’ve gained working in those countries back to the United States. We’ve started a project in Appalachia in Kentucky. We’re really excited about figuring out how to tackle the obesity-diabetes epidemics here in the US, focusing on the root behaviors — diet and exercise — that contribute to them.

In all of our global operations we’ve partnered with a range of institutions, because we believe these massive global health challenges are not challenges that can be solved by a single institution working alone. These are global problems and they need global solutions with the private sector, government, non-governmental organizations, and academic institutions working together. I think that is the model for the future: to get every single stakeholder involved and at the table.

One of those partners is the Queen of Jordan, who I hear recently made a visit to one of your micro-clinics.

Yes, we’re very fortunate to have the support of Her Majesty, Queen Rania, and also the Ministry of Health. She recently came to one of the areas where we are working. When she visited, she got to see first-hand how enthusiastic the participants of this program are about it, and how they’ve really taken ownership of it. Significant numbers of participants have lost weight and have reduced their blood sugar levels. These sorts of outcomes could have real implications for the health of the nation as a whole, because we want to replicate the program and spread it around the kingdom. Depending on how much we’re able to scale it, many thousands of lives and millions of dollars could be saved.

Queen Rania visiting a micro-clinic.

There are many aspiring social entrepreneurs out there who are trying to take their passion and ideas to the next level. What is one piece of advice you would give to them based on your own experiences and successes? Learn more about how to become a great social entrepreneur from all of the TED Fellows on the Case Foundation’s Social Citizens blog.

Be very, very cautious with your ideas, because ideas can be very good things, but they can also be very bad things.  A German poet once warned that ideas were so dangerous that they could in fact bring down entire nations.  At the same time I urge courage: take an idea that is sound and think about its implications. Think about how to test it on a smaller scale, where the damage can be limited if there are mistakes. If it’s successful, one can observe its success very clearly, and demonstrate that success before taking it to the next level.

That’s why we, as an organization, are doing what’s necessary to very rigorously test our ideas using the best scientific resources that we have available, to make sure that not only aren’t we doing any harm to the local communities, but that we are doing good.

You have a long-standing passion for the Middle East affairs, and have said you hope to address the violence there. What’s the link between that goal and Microclinic International?

Years ago, when I would talk to people about the program, I would say, “This is not simply a health problem. This is also a problem for governments and institutions concerned about stability, peace and security.” And in response I would maybe get a nod.

But this year we’ve seen the Middle East completely transformed. We don’t know how it’s going to turn out, but one thing that’s for sure is that things are changing quickly, and they are quite eruptive. I really believe that at the heart of the changes are people who are concerned about the basic essentials of life.

A few years ago, there was a major poll done in the Arab World, where people were asked, “What are the things that concern you most?” Not to my surprise, the first thing on the list was health. In my experience, people are really concerned with the most basic things in life. They’re concerned with, “Do I have adequate health care? Do I have adequate education? Is our family suffering financially? Do my kids have a job?” I really see our work in global health with Microclinic International, and more generally, the field of international development, as being inextricably linked to future peace and stability in the Middle East. There can never be a resolution between the nations of the region, there can never be internal harmony within the countries, until the most basic essentials are addressed. And I would put health right at the top of that list, because it affects every aspect of life. It affects the way families function, it affects the way they live their lives, it affects the way they work, their buying power, their ability to relax and to reduce stress levels.

There’s an old Arab proverb that says, “When there is health, there is hope. When there is hope, one has everything.” I think that really sums it up. The future of the region is really changing forever, and governments around the world really need to think seriously about evidence-based programs that improve the quality of life for people in the region. These things don’t have to cost a lot, but they have to be evidence-based, and in my view, some of the greatest challenges really have quite simple solutions.

With something as simple as changing our eating and exercising habits, we can combat major disease epidemics that some have said will rival the plagues of the Middle Ages. These simple steps can dramatically reduce human suffering, improve economic productivity, and create a more equitable and peaceful world.